Q: Dr. Eppley, I am 46 year old male. I was born with a high and wide forehead. I noticed some hair loss/thinning beginning about 15 years ago. I had a strip hair transplant surgery at that time with approximately 1,000 grafts. I used Propecia/Rogaine for years after the procedure with no change. I have been off those hair regrowth medications for years now with no change. I underwent an FUE hair transplant procedure last year of around another 1,000 grafts to improve and lower my hairline. As you can see from the attached pictures, there has been little hair growth with pitting and my forehead remains high and wide. Attached are pictures with a drawn in hairline. The approximate distance from my natural hairs behind the FUE grafts to the central point of my envisioned hairline is approximately 3.5 to 4 cms. Do you think I am a better candidate for another hair transplant or a hairline lowering procedure?
A: A hairline lowering procedure without a first stage tissue expansion will only bring the hairline forward maybe 2.0 to 2.5 cms centrally. With the prior occipital strip harvest (where scalp tissue is lost) that may limit even that amount of hairline advancement. In addition a hairline only brings the central part of the hairline forward and moves the temporal regions less so. While you understandably find your hair transplant results underachieving, the placement of a frontal hairline scar to move the hairline forward does not seem to be a worthy tradeoff with your existing hair density. I would suggest that further efforts should be directed towards additional hair transplants for your hairline lowering efforts.
Dr. Barry Eppley